4K8-10713-20369

3 vaccinations 11 coded responses 24 check-ins 11 free-text entries 1 call case

Sex: Male
Age at first dose: 66+
ZIP prefix: 853 / AZ
Registered: 2021-02-10

Relationship: Self
Race: Other
Ethnicity: Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-02-05
Dose 1 — Moderna
2021-02-10
Registered in v-safe
2021-02-10
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Redness, Swelling, Itching · None

Adult check-in
2021-02-11
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Itching · Headache, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-02-12
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Itching · Headache, Joint pains

Adult check-in
2021-02-13
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Joint pains, Muscle or body aches

Adult check-in
2021-02-14
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Muscle or body aches, Abdominal pain

Adult check-in
2021-02-15
Health check-in — day 7, dose 1
Feeling: Fair · Headache, Joint pains, Abdominal pain

Adult check-in
2021-02-22
Survey response — day 14, dose 1
MedDRA: Cough, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities

Free text: I have never lost my cough, But it has increased & last longer.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Survey response — day 21, dose 1
MedDRA: Cough — Feeling: Fair

Free text: My cough is not getting any better.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Dose 2 — Moderna
2021-03-08
Health check-in — day 0, dose 2
Feeling: Fair · Headache, Joint pains, Abdominal pain

Adult check-in
2021-03-09
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-10
Survey response — days 1–6 daily, dose 2
MedDRA: Adverse reaction — Feeling: Good · Headache, Muscle or body aches

Free text: All mild.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Survey response — days 1–6 daily, dose 2
MedDRA: Headache — Feeling: Fair · Chills, Headache, Muscle or body aches

Free text: Headaches more then ever!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-13
Survey response — days 1–6 daily, dose 2
MedDRA: Headache — Feeling: Poor · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Last 3 to 4 days Headaches have been Severe

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-14
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Chills, Headache, Joint pains, Fatigue or tiredness

Adult check-in
2021-03-15
Survey response — day 7, dose 2
MedDRA: Headache — Feeling: Poor · Headache, Joint pains

Free text: Headaches not getting better.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Survey response — day 14, dose 2
MedDRA: Headache, Self-medication — Feeling: Fair

Free text: Still have sever headaches, taking Tylenol, not helping.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-29
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-04-06
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-04-12
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-04-19
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-06-07
Survey response — 3 months, dose 2
MedDRA: Asthenia, Asthma, Cataract, Medical counselling, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities

Free text: I have stage 4 cataract on both eyes, according to my eye surgeon. Last year I had no cataract. He think Covid caused it.I still feel weak at times. My asthma has gotten worse.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-09-06
Survey response — 6 months, dose 2
MedDRA: Cataract, Impaired driving ability — Feeling: Good · Be unable to do your normal daily activities

Free text: Last year in January I went to optometrist for a new glasses,I was told then I had no cataract for someone my Age. I never got to order my glasses because of covid. Now I have stage four Cataract. Cant drive until I have cataract surgery.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-12-07
Dose 3 — Moderna
2022-03-08
Survey response — 12 months, dose 2
MedDRA: Asthma, COVID-19, Dyspnoea exertional, Lung opacity, Office visit, Pneumonia, Pre-existing disease — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: According to my pulmonologist I have broken glass like scar tissue on both lungs because of Covid & Pneumonia. My asthma is worse then ever. Hard time breathing just walking. · Healthcare visit (other): See my pulmonologist by appointment.

MedDRA releases: 2024-11 · check-in free text available
2022-03-08
Report sent to call center — 12 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-03-10
Call 1 — Left Voicemail
2022-06-08
Survey response — 6 months, dose 3
MedDRA: Asthma, COVID-19, Cough, Hospitalisation, Pneumonia — Feeling: Fair · Be unable to do your normal daily activities

Free text: My asthma & cough has gotten worse since I got out of the hospital back in January of this year after Covid & pneumonia.

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-05	Moderna
2	2021-03-08	Moderna
3	2021-12-07	Moderna	No

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 4 — day 14, dose 1

2021-02-22

Symptoms: I have never lost my cough, But it has increased & last longer.

Release 4 — day 21, dose 1

2021-03-01

Symptoms: My cough is not getting any better.

Release 5 — days 1–6 daily, dose 2

2021-03-10

Systemic reaction (other): All mild.

2021-03-12

Systemic reaction (other): Headaches more then ever!

2021-03-13

Systemic reaction (other): Last 3 to 4 days Headaches have been Severe

Release 5 — day 7, dose 2

2021-03-15

Systemic reaction (other): Headaches not getting better.

Release 6 — day 14, dose 2

2021-03-24

Symptoms: Still have sever headaches, taking Tylenol, not helping.

Release 8 — 3 months, dose 2

2021-06-07

Symptoms: I have stage 4 cataract on both eyes, according to my eye surgeon. Last year I had no cataract. He think Covid caused it.I still feel weak at times. My asthma has gotten worse.

Release 9 — 6 months, dose 2

2021-09-06

Symptoms: Last year in January I went to optometrist for a new glasses,I was told then I had no cataract for someone my Age. I never got to order my glasses because of covid. Now I have stage four Cataract. Cant drive until I have cataract surgery.

Release 11 — 12 months, dose 2

2022-03-08

Symptoms: According to my pulmonologist I have broken glass like scar tissue on both lungs because of Covid & Pneumonia. My asthma is worse then ever. Hard time breathing just walking.

Healthcare visit (other): See my pulmonologist by appointment.

Release 11 — 6 months, dose 3

2022-06-08

Symptoms: My asthma & cough has gotten worse since I got out of the hospital back in January of this year after Covid & pneumonia.

Each entry is dated by the survey it was written in (the CDC re-sent the releases with survey dates in 2025); click a date to see that survey response. The CDC cut some text off at about 250 characters: symptoms in every release, and the other two fields in releases 9-12. Those entries are marked "cut off by CDC".

MedDRA terms by release

Field	Preferred term	2021-09	2023-04	2024-11
HCVO	Office visit	·	·	✓
SD	Asthenia	✓	✓	✓
SD	Asthma	✓	✓	✓
SD	Cataract	✓	✓	✓
SD	Cough	✓	✓	✓
SD	COVID-19	·	·	✓
SD	Dyspnoea exertional	·	·	✓
SD	Headache	✓	✓	✓
SD	Hospitalisation	·	·	✓
SD	Impaired driving ability	✓	·	✓
SD	Lung opacity	·	·	✓
SD	Medical counselling	✓	✓	✓
SD	Office visit	·	·	✓
SD	Pneumonia	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Self-medication	✓	✓	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Headache	✓	✓	✓

✓ active code · ○ coded but marked inactive · blank = not in that release